Stillbirths at the mater Misericordiae hospital, Afikpo, southeast Nigeria – a review.

Abstract

Background: Stillbirths contribute significantly to fetal loss in poor sub-Saharan African countries. In Nigeria, affected parents often experience long-lasting grief. Objective: To determine the incidence of stillbirths at Afikpo, Southeast Nigeria. Methodology: A three-year retrospective review of all cases of stillbirths delivered at the Mater the
Misericordiae Hospital, Afikpo, was conducted. Results: Of 1859 babies, 199 stillbirths were delivered by 190 mothers, giving a stillbirth rate of 107 per 1000 total deliveries. The mean maternal age and parity were 27.6 years and 1.8 respectively. The major complications encountered by mothers in pregnancy were unexplained intrauterine death (31 or 16.3%), malaria and twin pregnancy, and in labour, unexplained intrauterine death (21.5%), obstructed labour, and ruptured uterus. One hundred and thirty-two stillbirths (66.3%) were delivered by spontaneous vaginal (vertex) delivery, 18.7% by caesarean section and 8.9% through laparotomy for ruptured uterus. Thirty (15.8%) of the mothers had severe morbidities and four died, giving a case fatality rate of 2.1%. The mean gestational age of the stillbirths was 37.3 weeks, and birthweight 2.5 kg. Fresh (67.3%) and male stllbirths (52.3%) dominated. The probable cause of stillbirth was documented in 61.3% of cases. Fetal distress (14.6%), obstructed labour and ruptured uterus were the major culprits. No stillborn underwent post-mortem confirmation of cause of death. Conclusion: Stillbirth rates reflect the standard of available obstetric services. Improving obstetric care could reduce it. Proper classification of stillbirths with autopsy confirmation of causes of death, will improve practice. A stillbirth programme incorporating community education will facilitate these.

Key words: stillbirths, pregnancy, labour, complications, Afikpo, Nigeria